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General NPI Number Information
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NPI Number | 1457225518
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Entity Type | Individual
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Provider Name | GNNANASRIBALA MUKKAMALA NP
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Gender | Female
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 01/11/2026
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Provider Practice Location Address
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Address Line | 3600 S GESSNER RD STE 200
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City | HOUSTON
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State | TX
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Zip | 77063-5150
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Country | US
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Telephone | 281-463-1400
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Fax | 281-463-1432
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Provider Business Mailing Address
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Address Line | 8319 HIDDEN TRAIL LN
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City | SPRING
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State | TX
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Zip | 77379-8723
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Country | US
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Telephone | 832-454-6042
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Fax | 281-605-6656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F09250582
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License Number State | TX
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